Journal Mobile Options
Table of Contents
Vol. 123, No. 2, 2012
Issue release date: November 2012

A Case of Fatal Fulminant Myocarditis Presenting as an Acute ST-Segment Elevation Myocardial Infarction and Persistent Ventricular Tachyarrhythmia Associated with Influenza A (H1N1) Virus in a Previously Healthy Pregnant Woman

Ona M.A. · Bashari D.R. · Tharayil Z. · Charlot A. · Hoskins I. · Timoney M. · Usmani S. · Royzman R.
To view the fulltext, log in and/or choose pay-per-view option

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

Several studies have reported influenza A (H1N1) virus as a cause of fulminant myocarditis. We report the first fatal case of fulminant myocarditis presenting as an acute ST-segment elevation myocardial infarction and ventricular tachyarrhythmia associated with influenza A (H1N1) in a previously healthy pregnant woman. A 38-year-old Asian woman, gravida 3, para 1-0-1-1, presented with flu-like symptoms. Initially, she developed wide-complex tachycardia requiring several defibrillations and was later intubated. Electrocardiogram showed ST-segment elevation. Coronary angiogram was negative and a pulmonary angiogram ruled out pulmonary embolism. Fetal compromise was noted on the monitor, and the patient underwent an emergent cesarean section. She subsequently expired. Autopsy confirmed severe myocarditis. Further testing confirmed influenza A (H1N1) virus. This case of a rare, yet lethal, complication of H1N1 infection underscores the importance of increased awareness among health care professionals to provide pregnant women with vaccination and prompt treatment.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Woodruff JF: Viral myocarditis. Am J Pathol 1980;101:425–484.
  2. Chan K, Meek D, Chakravorty I: Unusual association of ST-T abnormalities, myocarditis and cardiomyopathy with H1N1 influenza in pregnancy: two case reports and review of literature. J Med Case Rep 2011;5:314–318.

    External Resources

  3. Jamieson DJ, Honein M, Rasmussen S, et al: H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet 2009;374:451–458.
  4. Louie JK, Acosta M, Jamieson D, et al: Severe 2009 H1N1 influenza in pregnant and postpartum women in California. N Engl J Med 2010;362:27–35.
  5. Mamas MA, Fraser D, Neyses L: Cardiovascular manifestations associated with influenza virus infection. Int J Cardiol 2008;130:304–309.

    External Resources

  6. Martin SS, Hollingsworth CL, Norfolk SG, Wolfe CR, Hollingsworth JW: Reversible cardiac dysfunction associated with pandemic 2009 H1N1 influenza A. Chest 2010;137:1195–1197.

    External Resources

  7. Bratincsak A, El Said HG, Bradley JS, Shayan K, Grossfeld PD, Cannavino CR: Fulminant myocarditis associated with pandemic H1N1 influenza A virus in children. J Am Coll Cardiol 2010;55:928–929.

    External Resources

  8. Li YD, Hsiao FT, Lai CP, Chen CW: Acute myocarditis mimicking ST elevation myocardial infarction: manifestation on cardiac magnetic resonance. Acta Cardiol Sin 2010;26:44–47.

    External Resources

  9. Mottard N, Mewton N, Bonnefoy E, Abdellaoui M, Revel D, Kirkorian G: Acute myocarditis mimicking lateral myocardial infarction. Anaesth Intensive Care 2008;36:739–742.
  10. Vikerfors T, Stjerna A, Olcen P, Malmcrona R, Magnius L: Acute myocarditis: serologic diagnosis, clinical findings and follow-up. Acta Med Scan 1988;223:45–52.
  11. Monga M: Maternal cardiovascular, respiratory and renal adaptation to pregnancy; in Creasy R, Resnik R, Iams J, Lockwood C, Moore T (eds): Creasy and Resnik’s Maternal Fetal Medicine, Principles and Practice, ed 6. Philadelphia, Saunders Elsevier, 2009, pp 101–109.
  12. Siston AM, Rasmussen S, Honein M, et al: Pandemic 2009 influenza A (H1N1) viral illness among pregnant women in the United States. JAMA 2012;303:1517–1525.

    External Resources

  13. Liu SL, Wang J, Yang XH, et al: Pandemic influenza A (H1N1) 2009 virus in pregnancy. Rev Med Virol 2012, E-pub ahead of print.
  14. Arbit B, Gaultier CR, Schwarz ER: H1N1 virus infection associated with acute myocardial infarction in a young patient without coronary artery disease – first reported case. Acta Cardiol 2011;66:807–810.

    External Resources

  15. Centers for Disease Control and Prevention: Influenza vaccination coverage among pregnant women – 29 states and New York City, 2009–10 season. MMWR Morb Mortal Wkly Rep 2012;61:113–118.
  16. Tamma PD, Ault KA, del Rio C, Steinhoff MC, Halsey NA, Omer SB: Safety of vaccination during pregnancy. Am J Obstet Gynecol 2009;201:547–552.
  17. Centers for Disease Control and Prevention: Influenza vaccine coverage among pregnant women – United States, 2010–2011 influenza season. MMWR Morb Mortal Wkly Rep 2011;60:1078–1082.


Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50